AB0571 DO ADULT WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS REACH FITNESS STANDARDS FOR MAINTAINING PHYSICAL INDEPENDENCE IN LATER YEARS? ASSOCIATIONS WITH FATIGUE AT 2-YEAR FOLLOW-UP
Authors: B. Gavilán Carrera, A. Soriano Maldonado, J. A. Vargas-Hitos
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Maintaining physical fitness (i.e. muscle strength and cardiorespiratory fitness) is a key factor in preserving independence in later years [1]. Because people with systemic lupus erythematosus (SLE) present with reduced fitness levels [2,3], this population could be at risk of premature loss of independence. In addition, higher levels of physical fitness have been related to better SLE symptomatology, including fatigue [2,3], one of the most limiting symptoms. However, it is unclear whether physical fitness have a predictive role on future levels of fatigue in this population. <h3>Objectives</h3> This study aimed to analyze, in a sample of adult women with SLE: i) the proportion of participants that reach the proposed standards of fitness for muscle strength and cardiorespiratory fitness to maintain independence in the later life and ii) the association between reaching these standards of fitness and fatigue levels at 2-year follow-up. <h3>Methods</h3> This follow-up study included a total of 26 women with SLE (age: 41.3 ± 13.3 years) with low disease activity index (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.0 ± 1.9). The 30-s chair stand and 6-min walk tests from the Senior Fitness Test Battery were used to assess muscle strength and cardiorespiratory fitness. The percentage of participants reaching the criterion-reference for women 60-64 years old (15 repetitions [in the 30-sec chair stand test] and 571,5 meters [in the 6-min walk test]) was calculated. Linear regression models adjusted by age were used to analyze the association of reaching the fitness criterion-reference and fatigue levels at 2-year follow up. Five dimensions of fatigue (general, physical, reduced activity, reduced motivation and mental fatigue) were assessed using the multidimensional Fatigue Inventory (MFI). <h3>Results</h3> A total of 42.3 % participants did not reach the criterion-reference for muscle strength and 50 % of participants did not reach the criterion-reference for cardiorespiratory fitness. Reaching the criterion-reference for cardiorespiratory fitness was associated with lower physical fatigue at 2-year follow-up (β=-0.55, <i>P&lt;</i>0.05). There was no association with other dimensions of fatigue or reaching the criterion-reference for muscle strength. <h3>Conclusion</h3> In this relatively small sample of adult women with SLE, up to half of participants have reduced physical fitness that exposed them to a premature loss of functioning and independence in their later life. Reaching a minimum level for cardiorespiratory fitness, but not for muscle strength, predicted lower physical fatigue in the future. Exercise interventions aimed at increasing physical fitness could be a promising approach to reduce the decline in functioning and contribute to lower fatigue in this population. <h3>References</h3> [1]Rikli RE, Jones CJ. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist 2013;53:255–67. [2]Balsamo S, da Mota LMH, de Carvalho JF, Nascimento D da C, Tibana RA, Santos de Santana F, et al. Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study. BMC Musculoskelet Disord 2013;14:263. https://doi.org/10.1186/1471-2474-14-263. [3]Keyser RE, Rus V, Cade WT, Kalappa N, Flores RH, Handwerger BS. Evidence for aerobic insufficiency in women with systemic lupus erythematosus. ARTHRITIS Rheum CARE Res 2003;49:16–22. https://doi.org/10.1002/art.10926. <h3>Acknowledgements</h3> The authors would like to thank the study participants for their collaboration. We also gratefully acknowledge the members of the Internal Medicine Department for their support during data collection. <h3>Disclosure of Interests</h3> None Declared.